On the Market: Where's My Equipment?

With the implementation of Wi-Fi systems at healthcare facilities for Internet and voice over Internet protocol (VoIP), there has been a corresponding growth in the use of real-time location systems (RTLS). While the wireless infrastructure can be used, other technologies with other infrastructures offer healthcare customers the ability to know the location of an object or person in a facility. Based on that understanding, the facility owner or manager can improve efficiency in a number of ways.

RTLS provide healthcare facilities with information. A tag can be attached to an asset, such as a wheelchair, and be used to track the location of that wheelchair to know where it is and where it has been. This allows interested parties to locate missing items as well as know when they have been maintained, sterilized or laundered. The same can be done to locate patients or staff members. By knowing where a patient is, for example, as they move through different areas in the emergency department, a hospital staff member can track whether that patient has completed X-rays, how long he or she has spent in an examining room, and even which doctor visited him or her and for how long.

A 2007 Garner industry research paper, “Hype Cycle for Healthcare Provider Applications and Systems,” found that the best way to ensure equipment can be found, and that it has gone through appropriate decontamination, is by using wireless real-time locating systems, such as radio frequency identification (RFID), ZigBee, Wi-Fi or infrared.

Knowing where patients and assets are can strongly benefit any healthcare facility. A Universal Hospital Services study found that national average use of equipment is 45 percent; the remaining percentage represents time that items are simply not in use because they can’t be found, haven’t completed their maintenance, or have been hoarded by staff members.

RTLS are also used for tracking temperatures of coolers that store pharmaceuticals and tissues. In this case, tags can transmit regular temperature readings to the backend system, where that data can be stored or alerts sent. This helps hospitals meet Joint Commission on Accreditation of Healthcare Organizations (JCAHO) regulations that the cooler temperatures be recorded daily to prove that the contents have not been exposed to potentially harmful temperatures.

The technology choices can be confusing for facility owners, and companies that install the systems offer a variety of experience. So what would be helpful for installers to know in order to communicate to the owner and create the most effective system? To start, Wi-Fi systems can build off an existing wireless network. If the hospital already has an 802.11 communications system in place for Internet and phone coverage, that system can be used to locate those phones and laptop computers with the help of software provided from a variety of RTLS companies, such as AeroScout, Redwood City, Calif., or Ekahau, Reston, Va. By adding tags and sensors that transmit to the Wi-Fi nodes—with data in the backend system associating the ID number on the tag with the item to which it is attached—just about anything can be tracked throughout the facility. However, although the technology might be advertised as “plug and play,” often infrastructure needs to be added and that requires running cable. The Wi-Fi nodes or access points need to be placed densely to properly receive location data from tags. That means around 30 feet in density throughout a large facility and in areas where coverage often isn’t already installed such as basements, laundry facilities and storage areas. These are areas that haven’t required Internet or phone access, but where tagged items can often end up. For contractors or integrators, Wi-Fi expansion requires running Ethernet cable to each node.

Locating where nodes may be needed is accomplished by a walk-through of the target area using a laptop or other mobile device to sample signal strength.

However, other systems boast a greater granularity (the pinpointing of an item’s location more closely). The installation of which may require installing fiber to carry data from RFID readers installed in ceilings, doorways or walls. In this case, an RFID tag transmits to those readers, the tag’s location is identified through signal strength or triangulation, and the data is made available on a server the staff members access from their PCs and laptops.

Infrared technology offers its own advantages. In the case of a healthcare facility, infrared light bursts are detected by a receiver; the tag can transmit that light, which is received by a fixed IR sensor, or the fixed IR sensor can take the role of light emitter. In this case, the tag that happens into the area detects that light and then sends its ID number to the backend system. In some cases, RFID is used for a hybrid solution. Like an RFID system, infrared technology requires installation of fiber and cable for power to those sensors and readers.

On the other hand, Zigbee-based networks don’t require infrastructure. Solutions, such as one by AwarePoint, San Diego, have sensor nodes that are plugged into outlets. The tags that enter the mesh network are located and displayed on a server.

Increasingly, integrators are specifying and installing these RTLS, through relationships with the technology vendors, and are often programming the software. In other cases, they contract the cabling tasks to electrical contractors who have experience in RTLS and in working in the healthcare environment.

However, the system’s success requires that they be appropriately advertised and installed according to those promises. Ensuring the RTLS solution covers the entire campus is the most critical element to an installation. Installing it in a nondisruptive fashion quickly will also make the difference between a satisfied and dissatisfied customer.

RTLS technology is becoming more prevalent despite the slumped economy, according to a study by market research firm ABI Research, because it is proving its return on investment for hospitals. With the systems, facility managers or administrators are better able to find their missing equipment, reduce rentals and track the movement of patients.

And, it doesn’t matter what technology is deployed, as long as value can be conveyed to those with tight budgets.

“Healthcare facilities need to be guaranteed of the value they’ll realize from technology they install,” said Dan Pelino, general manager, Healthcare and Life Sciences at IBM. “Achieving meaningful use is one of the most significant issue facing the industry today.”

That goes far beyond RTLS to data security and software packages such as electronic medical records (EMRs) and health IT; it involves a tight timeframe and proving the value of health IT in order to reach those deadlines. There is no shortage of EMR and health IT solutions on the market, Pelino said, but the key to proving meaningful use and value for these systems lies in the ability to really use the data they create. Analytics help hospitals improve the health of their patients, improve their overall efficiency and ensure patient safety.

In the next few years, there will be continued rapid adoption of technology in healthcare, more use of wireless communications technology and more pervasive use of devices in the home, Pelino predicted. Greater secure sharing of health information has resulted from the creation of new Health Information Exchanges encouraged by the American Recovery and Reinvestment Act. There will also be an increased adoption of new secure computing platforms to help healthcare providers, such as cloud-computing systems that can help even small doctors’ offices get online with EMR systems.

Ultimately, technology is pushing a shift in the way patients are cared for, and a more collaborative model, made possible by the greater access to data, will lead the healthcare industry further toward a team approach to care.